Individual provider Active NPI

Tamika Pegues, DPT

  • Physical Therapist
  • Knightdale, NC
National Provider Identifier
1144503434
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9327 Issued in NC
Practice address
1000 Tandal PL
Knightdale, NC 27545-8842
Phone
(919) 295-5180
NPI assigned
Sep 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9327 NC Primary

Addresses

Primary practice location

1000 Tandal PL
Knightdale, NC 27545-8842

Mailing address

1000 Tandal PL
Knightdale, NC 27545-8842

Other practice location 1

1995 E Cornelius Harnett Blvd
Lillington, NC 27546-8276
Phone (910) 814-0880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TN, GA, NC4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20240319001664 SC Practitioner - Physical Therapist in Private Practice 5193162725 Reassigns benefits to 1 organization
I20250123002804 TN Practitioner - Physical Therapist in Private Practice 5193162725 Reassigns benefits to 1 organization
I20260128003584 GA Practitioner - Physical Therapist in Private Practice 5193162725 Reassigns benefits to 1 organization
I20260220001202 NC Practitioner - Physical Therapist in Private Practice 5193162725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Broad River RehabilitationGroup PAC ID 3375801350, 210 clinicians

Practice addresses (Care Compare)

1000 Ridge Crest LN
Mount Airy, NC 27030-2457
Phone (336) 515-6013

119 Bryan Ave
Manchester, TN 37355-2585
Phone (931) 345-2655

504 Firetower Rd
Dublin, GA 31021-2642
Phone (478) 606-0582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9327NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Broad River Rehabilitation Physical Therapist CurrentSince Jan 18, 2024 Accepting new patients
Integrated Senior Care PC PastSince Nov 1, 2025 Accepting new patients

Locations

504 Firetower Rd
Dublin, GA 31021
Phone (478) 606-0582

500 Eagle Lake Trl
Rome, GA 30165
Phone (706) 728-3600

1 Pond St
Arden, NC 28704
Phone 82877452220027

1000 Ridge Crest Ln
Mount Airy, NC 27030
Phone (336) 515-6013

915 W Cooksey Dr
Thomasville, NC 27360
Phone (336) 313-0224

3959 Fish Hatchery Rd
Gaston, SC 29053
Phone (803) 755-6541

119 Bryan Ave
Manchester, TN 37355
Phone (270) 993-4789

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1144503434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TANDAL PL",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TANDAL PL",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275458842",
            "telephone_number": "919-295-5180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1995 E Cornelius Harnett Blvd",
            "address_purpose": "LOCATION",
            "city": "Lillington",
            "state": "NC",
            "postal_code": "275468276",
            "country_code": "US",
            "telephone_number": "910-814-0880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEGUES",
        "first_name": "TAMIKA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "9327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.